MAC 2000 ECG Analysis System - GE Healthcare...8. Select the ECG key on the keyboard to record and print an ECG. 9. If you have your system set to Preview before Analysis, select Continue

2053535-065 Rev E

MAC® 2000 ECG Analysis SystemQuick Reference Guide

GE Healthcare

Global Customer Education

Notice

The materials contained in this document are intended for educational purposes only. This document does not establish specifications, operating procedures or maintenance methods for any of the products referenced. Always refer to the official written materials (labeling) provided with the product for specifications, operating procedures and maintenance requirements.

Contents

Skin Preparation and Resting 12-lead Placement. . . . . . . . . . . . . . . . . . . 1

Skin Preparation and Stress ECG Lead Placement . . . . . . . . . . . . . . . . . . 2

Patient Data (ADT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Patient Data (Simple Orders) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Patient Data (Advanced Order Manager) . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Acquire an ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Print Continuous Rhythm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

RR Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Acquire an Arrhythmia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Acquire a Stress ECG Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

File Manager . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Exporting to SD Card. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

1

Skin Preparation and Resting 12-lead Placement

1 2

3

4 5 6

9 8

10 7

1 V1 red C1 red Fourth intercostal space at the right sternal border

2 V2 yellow C2 yellow Fourth intercostal space at the left sternal border

3 V3 green C3 green Midway between location 2 and 4

4 V4 blue C4 brown Mid-clavicular line in the fifth intercostal space

5 V5 orange C5 black Anterior axillary line on the same horizontal level as 4

6 V6 purple C6 purple Mid-axillary line on the same horizontal level as 4 and 5

7 LA black L yellow Left wrist

8 LL F green Above left ankle (Alternate placement, upper leg as close to torso as possible)

9 RL green N black Above right ankle (Alternate placement, upper leg as close to torso as possible)

10 RA white R red Right wrist

Lead AHA Label IEC Label Description

The quality of your ECG tracing is a direct result of skin prep and lead placement.

1. Ensure that skin is dry, clean and remove excessive hair.

2. Mark each electrode site with a felt tip pen.

3. Degrease each site with a skin preparation cream.

4. Use a mild abrasion to remove the mark left by the felt tip pen.

5. Apply the electrodes to the prepared sites.

6. Look at the hook-up advisor and on-screen messages for indication of lead problems.

Skin Preparation and Resting 12-lead

Placement

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Preparing the patient correctly of their ECG is a critical part of making sure that the reading is accurate and free of noise. Here is what is suggested for a proper patient prep.

1. Ensure that skin is dry, clean and remove excessive hair.

2. Mark each electrode site with a felt tip pen.

3. Degrease each site with a skin preparation cream.

4. Use a mild abrasion to remove the mark left by the felt tip pen.

5. Apply the electrodes to the prepared sites.

6. Look at the hook-up advisor and on-screen messages for indication of lead problems.

Skin Preparation and Stress ECG Lead Placement

1 2

3

4 5 6

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3

1 Fourth intercostal space at the right sternal border

2 Fourth intercostal space at the left sternal border

3 Midway between 2 and 4

4 Mid-clavicular line in the fifth intercostal space

5 Anterior axillary line on the same horizontal level as 4

6 Mid-axillary line on the same horizontal level as 4 and 5

10 Recommend placing in the soft fleshy area just below the right clavicle

7 Recommend placing in the soft fleshy area just below the left clavicle

9Recommend placing on the corresponding right side of the thorax at the lower edge of the rib cage, or at the lower level of umbilicus at the right mid-clavicular line.

8Recommend placing on the corresponding left side of the thorax at the lower edge of the rib cage, or at the lower level of umbilicus at the left mid-clavicular line.

Lead Electrode Placement

Skin Preparation and Stress ECG Lead Placem

ent

4

Patie

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(AD

T)

Patient Data (ADT)

The MAC 2000 allows you to download patient demographics via an ADT interface. You can download patient demographics using internal or external keyboard, or barcode reader. Use the following procedures to query the database and select patient demographic for each.

Database Query Using Barcode Reader

1. Select Resting ECG.

2. Select the Patient Data.

3. Scan the patient barcode using the barcode reader. A dialog box opens with the scanned Patient ID.

4. Click OK to accept the selection.

5. The patient demographic data is populated. Modify any fields as necessary.

6. Select Save.

Database Query Using Internal or External Keyboard1. Select Resting ECG.

2. Select the Patient Data. A dialog box opens instructing you to enter the Patient ID.

Resting ECG Arrhythmia Stress ECG MoreFile Manager SystemConfiguration

Patient Data 25 mm/s 10 mm/mV More150 Hz Pace EnhanceOff

3. Enter the Patient ID using the internal keypad or external keyboard. A dialog box opens with the Patient ID you entered.

4. Click OK to accept the selection.

5. The patient demographic data populated. Modify any fields as necessary.

6. Select Save.

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Patient Data (Sim

ple Orders)

Simple Orders

Simple Orders provides an interface to quickly download and execute one order at a time. Use the following steps to execute a simple order.

1. Select Resting ECG

2. Select More.

3. Select Orders.

Note! If Auto Execute Single Order setting is enabled in Resting ECG Setup and only one open order for that given location is present the system will automatically download that single order and populate the Patient Information screen.

4. Select an order from the list.

5. Select Load.

6. The order will download and populate the Patient Data screen. Modify as patient data as necessary.

7. Select Save.


Patient Data 25 mm/s 10 mm/mV More150 Hz Pace EnhanceOff

Printer LeadsRhythm 6

ADSOn

Orders MoreMain Menu

Cancel Page Up LoadPage Down

Patient List Cancel SavePage Down

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Advanced Order Manager

Advanced Order Manager provides an interface to download and store multiple orders on the system and execute them later. Use the following procedure to execute an advanced order.

1. From the Main Menu, select More.

2. Select Order Manager.

3. Select Load Orders.

4. Enter the location(s).

Note! To query multiple locations, add a comma between each location number e.g. 1,2,5,7.

5. Select Ok.


Order Manager RR Analysis More

Select Load Orders Delete Orders Main MenuSort Orders Print

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Patient Data (Advanced O

rder Manager)

Patient List Cancel SavePage Down

Cancel Load OrdersPage Up Page Down

Select Load Orders Delete Orders Main MenuSort Orders Print

6. Select the order(s) from the list.

7. Select Load Orders.

8. Select Select.

9. Select an order.

10. Select Ok to confirm the order selection.

11. Select Patient Data to open with the patient information screen which will be populated from the selected order.

12. Modify the patient and test data as necessary.

13. Select Save.

Cancel OK

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ECG

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Acquire an ECG1. Prepare the patient.

2. Open the Resting ECG function in one of two ways:

• Power on the unit or

• From Main Menu select Resting ECG.

3. Verify waveform quality by:

• Checking Hook-up Advisor. Green indicates a good quality waveform.

• Cycle through the lead groups to visually verify lead quality by selecting the Leads key on the keyboard.

4. Use the appropriate keys to make adjustments to (if necessary): • Speed • Gain • Filter

5. Select Patient Data to enter the patient information.

6. Select Page Down to access other Test Information windows.

7. Select Save to save and close the Patient Data window.

8. Select the ECG key on the keyboard to record and print an ECG.

9. If you have your system set to Preview before Analysis, select Continue to proceed to analyze and print an ECG or Cancel to cancel the analysis.

10. If finished, continue with step 11, or continue with these options:

• Select Print to print another copy

• Select Save if the unit is not set to save the ECG automatically.

• Select Transmit to transmit that single record to the default transmit location.

• Select Next Patient to start a new patient or Select the ECG key to take another ECG on the same patient.

11. When finished, do one of two things:

• Proceed to File Manager to transmit records. (See Transmit Stored Records.)

• Turn the unit off and plug it into AC power.

Note! Steps 1, 5 and 8 are the minimal basic steps for acquiring an ECG. All other steps are only used as required depending on options and features turned on.

LeadsECG

9

Print Continuous Rhythm1. Prepare the Patient.

2. Open the Resting ECG function in one of two ways:

• If the select default power on option is Resting ECG, simply power on the unit or

• From Main Menu select Resting ECG

3. Verify waveform quality by:• Checking Hook-up

Advisor. Green indicates a good quality waveform.

• Cycle through the lead groups to visually verify lead quality by selecting the Leads key on the Keyboard.

4. Use the keys to make adjustments to (if necessary):

• Speed • Gain • Filter

5. Select Patient Data to enter patient information.

Print Continuous Rhythm

6. Select Page Down to access other Test Information windows

7. Select Save to save and close the Patient Data window.

8. Select the Rhythm key on the keyboard to print a continuous rhythm.

9. Select the Stop button to stop printing.

Note! Rhythm reports are not stored to File Manager.


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Power Leads StopRhythm

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RR A

naly

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Printing an RR Analysis Report (not sold in all countries)

Use the following steps to generate an RR Analysis report.

1. Prepare the patient.

2. From the Main Menu select More.

3. Select RR Analysis. You can also access RR Analysis from the Resting ECG mode after an ECG has been acquired.

4. Select Patient Data and enter the patient data.

5. Adjust the setup options (target, record lead, gain, speed, filter, pacemaker detection, rhythm record, and

RR table) as necessary by selecting RR Analysis Setup.

6. Select Start Test to start the test.

When the target is achieved, a preview of the summary results, histogram, and trendgram are shown on the display.

Note! You may select Stop Test to stop the test prior to the reaching the target.

7. While reviewing the preview, do any of the following:

• To discard the reading and begin over, select Return. and repeat from Step 5.

• To discard the reading and return to the Main Menu, select Main Menu.

• To accept the reading and print the report on the thermal printer, select Print

• To accept the reading and export the results as a PDF file, select PDF Export.

Note! Steps 1, 4 and 6 are the minimal basic steps for acquiring RR Analysis.

Start Test Patient Data Main MenuRR Analysis Setup

Print PDF Export Main Menu Return

Resting ECG Arrhythmia Stress ECG System Configuration

File Manager More

Order Manager RR Analysis More

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2

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4

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Acquire an Arrhythmia

Acquire an Arrhythmia5. Select Save to save and close

the Patient Data window.

6. Verify waveform quality by:

• Checking Hook-up Advisor. Green indicates a good quality waveform.

• Cycle through the lead groups to visually verify lead quality by selecting the Leads key on the Keyboard.

7. Make adjustments to (if necessary):

• Speed • Gain • Filter

8. Select Start Recording.

9. Select Stop Recording.

10. Select Confirm Stop to stop the recording or Continue Recording to continue to collect information.

11. After the recording is stopped, select the type of Arrhythmia report you wish the printout to include: Summary Report, Table Report, or Episode Report.

12. Select Main Menu.

Note! Steps 1, 3 and 8 are the minimal basic steps for acquiring an ECG.

1. Prepare the Patient.

2. Open the Arrhythmia function in one of two ways:

• If the select default power on option is Arrhythmia, simply power on the unit or

• From Main Menu select Arrhythmia

3. The Patient Data window automatically opens. Enter the desired information.

4. Select Page Down to access other Test Information windows.

Start Recording 12.5 mm/s5 mm/s

10 mm/mV More150 Hz


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Start recording button

Leads button

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Stress ECG Testing Keyboard

The Stress ECG test keys are located at the top of the stress test keyboard. These keys are used to control the functions of the stress test as well as the connected stress device.

1. Pretest: Advanced the test to the Pretest Phase or while in the Pretest Phase if selected will advance to the next stage in that phase.

2. Recall: Prints a one-page rhythm strip report using the previous 10 secs of data from the point from which you select the Recall key

3. Exercise: Advanced the test to the Exercise Phase or while in the Exercise Phase if selected will advance to the next stage in that phase.

4. 12 Ld: Prints a 12 lead report.

5. Recovery: Advances to the Recovery phase or while in the Recovery Phase if selected will advance to the next stage.

6. Medians: Prints a median report. Set the type of median report you wish to print in the Stress Setup window under In-test Reports.

7. Test End: Ends the current test. When a confirmation message appears on the screen, select the desired function key.

8. Comment: Allows you to enter comments about the test. Comments are printed on the Tabular Summary Report. You can enter up to 100 characters.

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Pretest Exercise Recovery

Recall 12 ld Medians

Test End Hold Stage Speed W+ Grade Tmil

Comment Enter BP Speed W- Grade Tmil

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Acquire a Stress ECG Test

9. Hold Stage: Maintains the current test stage and doesn’t allow the protocol to go to next stage. Select again to remove the stage hold and to go back to programmed protocol staging.

10. Enter BP: Allows you to enter a Blood Pressure reading manually or triggers a reading for a supported external device.

11. Speed W+: Increase treadmill speed or ergometer load. Selecting this button will result in the system no longer following the selected protocol and places the system in manual mode.

12. Speed W- : Decreases treadmill speed or ergometer load. Selecting this button will result in the system no longer following the selected protocol and places the system in manual mode.

13. Grade : Increase treadmill incline. Selecting this button will result in the system no longer following the selected protocol and places the system in manual mode.

14 Grade : Decrease treadmill incline. Selecting this button will result in the system no longer following the selected protocol and places the system in manual mode.

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15. Tmil >: Starts the Treadmill

16. Tmil•: Stops the Treadmill

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Accessing Stress ECG Mode

The Stress ECG mode is a purchasable option and allows you to conduct a Stress ECG test with a direct connection to treadmill or ergometer. Regardless of the devices the basic procedure for conducting a Stress ECG test is the same. Now let’s access the Stress ECG menu.

1. Select Stress ECG from the Main Menu.

2. Select Patient Data and enter the appropriate data.

3. Select More.

5. You can also turn Pace Enhance On or Off, select the Printer Leads, select Report Formats or change the Target HR.

Note! In setups you can automatically set the Target HR % that you wish to achieve. This number is calculated against the patient’s age.

Resting ECG Arrhythmia Stress ECG System Configuration

File Manager More

Patient Data 25 mm’s 10 mm/mV FRFOn

More

Pace Enhance Off

Printer Leads12

Select Protocol Target HR MoreReport Format

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4. Select Protocol to choose desired protocol. The default protocol will be chosen, however you can select another protocol from the list. If you do select a new protocol, select Save.

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Acquire a Stress ECG TestPretest Phase

A Stress ECG protocol typically is composed of 4 phases. These include Pretest, Exercise Recovery and Test End.

Pretest allows the user to take ECG and blood pressure measurements in a variety of patient positions. Depending on the protocol, it is also a phase that could be used to allow the patient to warm-up before the Exercise portion of the Stress ECG test.

1. Select the Pretest button on the keyboard to enter the Pretest Phase.

2. Select the BP button on the keyboard and enter patient’s blood pressure.

3. Select the 12 ld button on the keyboard to take a 12-lead ECG

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4. Select the Pretest button to advance through the Standing and Hypervent stages a BP and 12-lead as required.

5. Select the Pretest button to advance to Warm-up.

6. Select the Tmil> button to start the treadmill.

7. Have the patient start to walk at speed based on the selected protocol.

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Exercise Phase Once the patient is comfortable walking on the treadmill or peddling on the ergometer, select the Exercise key on the keyboard to start the Exercise Phase. The phase will now indicate Exercise and the stage time and workload will be dictated by the protocol.

1. Select the Exercise button on the keyboard. The system will now enter the exercise phase and follow the selected protocol. Select the Exercise button a second time will advance the protocol to the next stage.

Note! Selecting the Speed or Grade controls for the treadmill or ergometer will result in the system dropping out of the protocol. At this point the user must

manually control the treadmill or ergometer’s workload.

2. Select the Hold Stage button will result in the stage being held at that workload for as long as the stage is held. Select Hold Stage a second time to release the stage to follow the selected protocol.

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Note! The stage time will turn red when the stage is in hold.

3. A blood pressure will be automatically prompted for based on the protocol or you can select the Enter BP button on the keyboard to enter a BP.

4. A 12 lead will be automatically taken by the system based on the protocol or you can select the 12 ld button on the keyboard to take a 12 lead. You may also take a median report at any time by selecting Medians.

5. Select the Recall button to capture the previous 10 sec of ECG that just pasted on the screen.

6. Select Comment on the keyboard to enter a patient related comment.

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17

Acquire a Stress ECG TestRecovery Phase

Once it is determined that the Exercise portion of the stress test has been completed, you will now select the Recovery button and enter into the recovery phase. The Recovery phase is opportunity to continue to monitor the patient to make sure their blood pressure, heart rate, symptoms and ECG return to their pretest values. The length of the Recovery Phase will depend on your clinician protocol.

1. Select the Recovery key on the function keyboard when the patient has reached peak exercise, or when you are ready to advance to the Recovery Phase.

2. On supported treadmills the speed and grade of the treadmill will gradually decrease according to the protocol.

3. The system will automatically print a peak 12-lead or median report according to the protocol.

4. BP will automatically be prompted based on the protocol.

5. Enter comments or take extra 12 leads or medians as needed.

6. Select Tmil• on the keyboard to stop the belt. If using an ergometer, have the patient stop peddling.

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2. Confirmation of ending the test appears. Select Confirm Test End to end test or select Continue Test to continue collecting data for the current patient.

3. Once you have selected Confirm Test End the following menu selections appear.

Confirm Test End Continue Test

1

Test End

Once the Recovery phase is completed you can select Test End on the keyboard and disconnect the leads from the patient.

1. Select the Test End key on the keyboard when ready to end the test.

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Acquire a Stress ECG Test

4. Select Print to print the default Summary Report Format.

5. If you desire to select different Summary Report components then originally chosen in the Stress Testing Setup, select Report Format to override those default selections. The following screen appears to allow you to select the different components.

6. Select Save to save your changes and select Print to print that Summary report.

7. Select Next Patient to conduct a Stress ECG test on the next patient. The system will verify that The previous test data will be lost. Do you wish to continue with the Next Patient?

Select Yes to continue

Note! Stress ECG test are not saved to the File Manager. Once you select to do you next patient all test data will be lost.

Next Patient Print Report Format Main Menu More

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File

Man

ager To Select Records:

1. From Main Menu select File Manager.

2. From File Manager you can select records to:

• Edit

• Preview

• Delete

• Print

• Transmit

• Import • Export

To Select All:1. Select Select All. All records

are selected.

2. Select the menu key of the desired function, such as Print.

To Select Individual Records: 1. Select Select.

2. Use the circles on the trimpad to highlight the record. Highlighted records are shaded in dark blue.

3. Select the middle of the trimpad to select the records. Selected records are then shaded in gray.

5. If needed, continue to select other records.

6. Select the menu key of the desired function, such as Print.

07/28/2008 15:01:41 90/200

Edit Preview Delete Transmit MorePrint

07/28/2008 14:58:04 90/200


Highlighted records are shaded in dark blue

Selected records are shaded in gray

Trimpad

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File Manager

Edit Stored ECG Records


2. Select Select to highlight the individual record to edit. You may only select one record to edit at a time.

3. Select Edit to edit the selected record.

4. Use the keys on the Trimpad to select the Patient Information to be edited.

5. Edit the data as required.

6. Select Page Down to access other Test Information Windows

7. Edit the data as required.

8. Select Save to save edited fields and close the data window.

9. Highlight the record using the Trimpad and select Print to print the edited record.

Delete Stored ECG Records


2. Select Select to select individual records to delete. Select All to select all records.

3. Select Delete.

4. A message will appear verifying whether you want to delete the selected record(s).

5. Select Yes to delete the record(s). Select No to cancel the delete function.

Select Select All Import Search Main MenuPrint Directory


Tier 1 F Keys for File Manager


Select individual records

Select all records

Edit a record

Delete a record Print the selected record(s)

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File

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Transmit Stored Records

1. From Main Menu select the key for File Manager.

2. Select Print Directory to print a list of stored files

3. Select Select All to select all records to transmit or select Select to select individual records.

4. Select Transmit to transmit selected records.

5. One of two things will happen:

• If only one location is defined, the file(s) will be transmitted to the default location.

• If multiple locations are defined, select the desired location and select Ok.

Preview Stored ECG Records

1. From the Main Menu select the key for File Manager.

2. Select Select to highlight the record to preview.

3. Select Preview.

4. The 12 lead display of the ECG record will be displayed.

5. Select Return to return to the File Manager main screen.

Print Stored ECG Records

1. From Main Menu select the key for File Manager.

2. Select Select to highlight an individual records to print. Select All to select all records.

3. Select Print to print the selected record(s) to the thermal printer.

Transmit record(s)

Print record(s)Preview record(s)

23

Exporting to SD Card

Select Select All Import Search Main MenuPrint Directory

Exporting to SD Card

1. Select Select to highlight individual records to export. Select All to select all records.

2. If you are exporting to an SD card, insert the card into the MAC 2000 SD Card Slot. Make sure the card has sufficient free space for the selected records and that it is not write protected. If there is not sufficient space on the SD card a message will appear indicating that.

3. Select More.

4. Select Export. The F keys change to allow you to select the format in which to export the data.

• To export the data in XML, skip to step 5.

• To export the data in PDF, proceed to step 8.

5. To export the data in XML, select Hilltop XML. One of two things happens:

• If a shared directory was defined, a window opens for you to select the destination.

Transmit Export Return MorePreview

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Export record(s)

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d 7. Select OK. The selected records are exported to the selected destination. A window opens to inform you of the export’s progress. The window closes when the export is complete.

Note! When exporting to a shared directory, the MAC 2000 device logs on to the directory with the user name and password defined on the Communications Setup window. If either of those values are incorrect, you will receive an error message. Correct the user name and password on the Communication Setup window and repeat the export process.

Skip to step 6.

• If a shared directory was not defined, the selected records are exported to the SD card.

A window opens to inform you of the export’s progress. The window closes when the export is complete.

6. Do one of the following:

• To export to the SD card, select SD Card in the window.

• To export to the shared directory, select Shared Directory in the window.

8. To export the data as a PDF, select PDF.

9. Follow steps 6 through 7.

2053535-065 Rev F

© 2015 General Electric Company – All rights reserved.

General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the product described at any time without notice or obligation.

GE, GE Monogram, Marquette, 12SL, MAC 2000 and MUSE are trademarks of General Electric Company. GE Medical Systems Information Technology, a General Electric company, doing business as GE Healthcare.

Notice: The materials contained in this document are intended for educational purposes only. This document does not establish specifications, operating procedures or maintenance methods for any of the products referenced. Always refer to the official written materials (labeling) provided with the product for specifications, operating procedures and maintenance requirements. Specifications are subject to change.

All patient names or other protected health information or data contained in any image within this material is fictitious. Any similarity to actual persons is coincidental.

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www.gehealthcare.comGE Healthcare provides transformational medical technologies and services that are shaping a new age of patient care.

Our broad expertise in medical imaging and information technologies, medical diagnostics, patient monitoring systems, drug discovery, biopharmaceutical manufacturing technologies, performance improvement and performance solutions services help our customers to deliver better care to more people around the world at a lower cost.

In addition, we partner with healthcare leaders, striving to leverage the global policy change necessary to implemental successful shift to sustainable healthcare systems.

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MAC 2000 ECG Analysis System - GE Healthcare...8. Select the ECG key on the keyboard to record and print an ECG. 9. If you have your system set to Preview before Analysis, select Continue